Y2L-20950-87639

3 vaccinations 7 coded responses 21 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 142 / NY
Registered: 2021-02-10

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-28
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-11
Survey response — day 14, dose 1
MedDRA: Back pain, Lumbar puncture, Neck pain, Procedural pain — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I had a lumbar puncture on 2/10/21 and today (2/11/21) I am having a great deal of neck and back pain, likely related to the lumbar puncture.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Diarrhea

Free text: Muscle cramp in legs. Side effects started 3 hrs post vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · None

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Swelling, Itching · Headache

Free text: Headache is probably not from vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia, Pain — Feeling: Fair · Muscle or body aches

Free text: Muscle pain around collarbone when bending- not typical!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Site: Swelling · Headache

Free text: I have chronic migraines & am experiencing one today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Call 1 — Left Voicemail
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Mastitis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Mastitis on July 9 · Healthcare visit (other): In-person doctors appointment

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 1 — Left Voicemail
2021-12-18
Dose 3 — Moderna
2022-03-04
Survey response — 12 months, dose 2
MedDRA: Malaise, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I think I had Covid the week of 2/14, but never tested positive. I did receive Evusheld pre exposure antibodies in January.

MedDRA releases: 2024-11 · check-in free text available
2022-03-20
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-18
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-12-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-12-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-11	Unsuccessful
2021-08-26	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-11

Symptoms: I had a lumbar puncture on 2/10/21 and today (2/11/21) I am having a great deal of neck and back pain, likely related to the lumbar puncture.

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Muscle cramp in legs. Side effects started 3 hrs post vaccine.

2021-03-01

Systemic reaction (other): Headache is probably not from vaccine

2021-03-02

Systemic reaction (other): Muscle pain around collarbone when bending- not typical!

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): I have chronic migraines & am experiencing one today

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Mastitis on July 9

Healthcare visit (other): In-person doctors appointment

Release 11 — 12 months, dose 2

2022-03-04

Symptoms: I think I had Covid the week of 2/14, but never tested positive. I did receive Evusheld pre exposure antibodies in January.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	✓	·	✓
SD	Back pain	✓	·	✓
SD	Lumbar puncture	○	✓	○
SD	Malaise	·	·	✓
SD	Mastitis	✓	·	✓
SD	Neck pain	✓	·	✓
SD	Procedural pain	○	✓	○
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release